“Together, families can understand the importance of accountability and healthy boundaries in enhancing recovery.”

By Michael L Gaziano LCSW,
Clinical Director, Recovery Ways

Family relations have always been complicated. Add a pandemic, an unprecedented election year, social racial injustice, and an increase in mental illness and, as you might expect, families are sharing more complex struggles than ever before. (Now that we are finally able to see them live and in person again!) It’s a whole new opportunity for all to heal, grow, and recover.


Danger or Opportunity?

The Chinese have two symbols for crisis; the first is danger. It is understandable with all the many challenges we have faced over past year that many families and loved ones were or are in crisis. Danger is around us all. However, the second character for crisis is opportunity. We have a great opportunity to adapt and build a resolve to move ahead as healthcare providers and families seeking help for their loved ones.
At Recovery Ways our family program has a strong foundation built on patients and families learning together how to support each other and allow space for their own innerchange and self-awareness. In my opinion as a Clinical Director with decades of experience, the most vital understanding to a family program is that “Healing is Possible.”

Throughout my years of working with families and patients, I have been able to gain an understanding of the complex challenges and concerns they face in regards to substance abuse disorder and how it has affected their family. There is a wealth of information and tools that can help the family heal together and mend the bonds of trust that have been broken.

The Three C’s

“The Three C’s” founded in Al-Anon can provide the vital insight families need to make positive changes. They are: Cause, Control, and Cure. In order to provide a safe space and a healthy path to innerchange, families and patients must learn that no one person or thing causes the behaviors and actions of another. One might feel inclined to place the blame on past trauma or substance use for current behaviors, and while they might contribute to the root of negative actions, they are not solely responsible.

Control, the second “C”, works to provide a better understanding of the fact that we cannot control the choices and behaviors of others. We learn that our attempts to do so will result in increased hurt, emotional pain, and possible resentment. The desire to control is often based on fear and frustration around the behaviors of loved ones. They fear the hurt they may cause to themselves and others, and feel frustration at having to watch the destruction that person is causing in their lives. This is where control really comes in. Many families are under the assumption that if their loved ones could just think rationally and see the damage their addiction is causing, they would simply stop doing it.
This type of thinking does not take into account that substance use and/or unresolved trauma is an illogical disease.

Families learn how their attempts to manage or control another person’s life do not work. It causes resentment, distrust, despair, and anger. Families’ efforts to ‘help’ may in fact enable and/or contribute to the ongoing problems and difficulty of their loved one’s life. Together, families can understand the importance of accountability and healthy boundaries in enhancing recovery and personal growth.
The third and final “C” puts the focus on a cure. This isn’t magic; it’s not a quick permanent fix. Rather, the cure encompasses both an understanding of the problem and the tools to live a healthier lifestyle and gain positive innerchange.

The additional “C”

An additional C in this discussion will fall on communication. Over years of work with children, adolescents, and adults one major conflict seems to be present in all families and relationship: “You don’t understand, you don’t listen, and you are blaming me.”

Communication can either foster compassion and care, or it can control, manipulate, and cause resentment. I have worked with others to build on a few key concepts to healthy communication which I like to call the “the essential ingredients to a recipe for healthy understanding and listening.”

First and foremost, we must be willing to take emotional risks in our relationships by reaching out and learning to communicate what we need and want. This means we will learn and grow in our relationship by engaging in them. Keep in mind we can’t just simply start off a conversation with someone without asking for permission to see if this is a good time to talk. I truly used to believe that when I was ready to talk; my spouse or family member must be automatically ready to listen. That is a misconception that many of us have believed to be true. Many times a person is not ready when you are — and we must be understanding when they say it isn’t a good time for them. It’s not a rejection, but rather an honest response to a question being asked. If someone isn’t ready to have a conversation, ask him or her when a good time would be. Let them know you have important things to share with them. Keep in mind that it would be better if that time was the same day and you can be honest with them about this as well. This leads to the next ingredient, which is honesty.


Honesty is a key concept in healthy communication as it allows for frank discussion without fear of conflict, blame, or judgment. We can be honest without being hurtful. We can learn to express open feelings without being on the offensive. The best way to express this is by using “I” statements rather than “You” statements.

“I” statements increase accountability and responsibility for our own feelings, behaviors, and emotions. When we start with “I,” we invite a discussion. When we start with “you,” we begin an interrogation or lecture. I know personally when someone starts with an “I” statement I’m more open to hearing what he or she has to say. People have a tendency to quickly go to a blame statement when they start with you.
Let’s now explore what happens when we think we are listening to someone, yet end up playing the “Point Game” instead. The game goes like this: “You did this…”, “oh yeah? Well, two weeks ago you did that…”, “Oh yeah? Well, a month ago you did all of these things…” And on it goes. Sound familiar? You’re not alone. Oftentimes the point game gets played due to fear that we won’t get our point across and thus lose an argument. However, even engaging in the point game is an automatic loss for both participants. We must be willing to find middle ground and compromise. This leads to next ingredient, which is to support differences of opinion without the need to be right.

I was presenting these concepts to a group of families who were learning how to communicate and share with their loved ones in treatment. I looked out in the audience and said “you can pick your mountain tops just don’t make it a mountain range.” In essence, this means you can find points you feel are important to hold onto and allow for differences of opinion on other points that might not be as important. This makes for a more balanced and respectful relationship. One more ingredient to consider is speaking to one another as equals thus avoiding a one-up-one-down relationship. I have found by learning to communicate my needs and feeling and following these ingredients, it has made for healthy communication and understanding. It’s important to restate that healing is possible when we learn to communicate our needs and put healthy boundaries around the things we no longer want to engage in with our loved ones. With these concepts in mind, let’s now move to ways that these can assist in addressing our concerns around trauma, substance use, and depression.

Families suffer so many traumas from grief and loss due to the destructive nature of substance use. I have truly come to the understanding that trauma has no expiration date. The experiences that impact families can start as early as infancy, and cause lasting trauma through to adulthood.

Let me share a personal example of how trauma can start in infancy. My mother and father actively campaigned for John F. Kennedy during the 1960 presidential election. My father worked tirelessly everyday on this campaign while my mother was pregnant with me. They spent long, taxing hours, striving to get their candidate elected. Needless to say, they were under extreme stress and tension at this time. So, when I was born in December of 1960, I arrived with my fists clenched and my body a bundle of raw nerves. The doctor looked at my mother and said, “You have an election baby.” During my childhood this in utero trauma revealed itself in other ways. I was a hyperactive child who had many challenges.

Trauma and nervous system regulation are tied closely together. We see that Adverse Childhood Experiences (ACEs) contribute to nervous system dysregulation. Many people are learning that some of their past childhood experiences that have been left unresolved are impacting their behaviors and emotions in the present.

Years of working with adolescents from families in crisis have rooted the importance of addressing trauma because of the impact it may have in later stages of development and adulthood. In my early years as a caseworker for child welfare, I had firsthand experiences of how childhood trauma due to emotional neglect, substance abuse, and other abuse can have a negative impact throughout life. Coping skills and the ability to problem solve suffer greatly because of this. There is a saying that “the body keeps the score” when it comes to trauma. A person may not feel they are affected in the present by past trauma. They may feel they don’t need to process experiences or emotions. But on a deeper level, the body does indeed keep the score, and in ways they might not realize, past trauma does affect them.

The term ‘dysfunctional families’ is often associated with feelings of guilt, shame, and fear. In family therapy, one comes to understand that dysfunction is part of the human experience. We break the word ‘dysfunction’ into two terms: dys means not, and functional means fun. A dysfunctional family is not fun, and every family goes through at least some time when things are just not fun. Not only does this take the scariness out of the word ‘dysfunctional,’ but it’s also a chance to reframe things and an invitation to engage in open, honest communication without blame, shame, or judgment. Processing trauma can create increased compassion and understanding within families, and give them better clarity on how to move forward on the path to healing.

The sustainability of recovery is fostered by ongoing support and family involvement. Family therapy helps members understand that relapse can happen, and that it’s not due to a lack of willpower, or a lack of commitment to stop. They all gain a better understanding that healing involves nervous system regulation, emotional support and, when indicated, medication management. Families realize that continual recovery comes from their own innerchange and support of others’ independent journey on their recovery path.

At Recovery Ways our program builds on compassion, patience, and understanding for each other, reducing resentments and building on a relationship of love and respect. The core piece to true innerchange is no longer enabling or rescuing another person, but rather developing a healthier understanding of substance use, trauma informed care, and support. With that core piece in place and a commitment to our own emotional health, “healing is possible.”

The human experience is difficult. No one goes through life without taking some damage, some hits, some disappointments, and some hurt. It’s part of what helps us to grow and progress if we use these experiences as teaching, strengthening lessons. We can readjust, adapt, make better choices, pull our loved ones close, and keep moving forward. We can encourage healing in our own lives and in the lives of those we love by not ignoring trauma, but by addressing it honestly and without judgment. Ashkay Dubey beautifully captures what healing is in his quote, “Healing doesn’t mean the damage never existed. It means the damage no longer controls your life.”

Michael L Gaziano LCSW is Clinical Director at Recovery Ways. For immediate help call 888.986.7848 To contact Michael email: [email protected] 1-801-326-5180 ext 1058. recoveryways.com